Leakage Rate of Ileo-COlic Sutured Anastomosis After Right Hemicolectomy

An anastomosis leak is defined as " leak of luminal contents from a anastomotic site between two hollow viscera" diagnosed (1) radiologically, by a radiographic enema with hydro soluble contrast or by computerized tomography with the presence of intra-abdominal collection adjacent to the anastomosis; (2) clinically with evidence of extravasation of bowel content or gas through a wound or drain; (3) by endoscopy, or (4) intraoperatively.

Anastomosis leak will be classified and graded according to Clavien-Dindo.

Grade I:

Anastomosis leakage requiring no active intervention (e.g. antibiotics)

Grade II:

Anastomosis leakage requiring active radiological intervention but manageable without surgical intervention.

Grade III:

Anastomosis leakage requiring surgical re-intervention.

Grade IV:

Anastomosis leakage leading to life-threatening condition requiring IC /ICU management

Grade V:

Anastomosis leakage leading to death of the patient

Stenosis

• bleeding
• hemmorage
• obstruction
• intradominal abszess
• ileus
• peritonitis
• sepsis

Superficial Surgical Site Infection and deep Surgical Site Infection rate according to CDC

Different dimensions rated by the surgeon using 5-point Likert scale. (1= best to 5=worse) A 5-point Likert scale is a survey tool that allows respondents to express their level of agreement or disagreement with a statement, providing nuanced feedback through five ordered response options.

Structure of a 5-Point Likert Scale

A typical 5-point Likert scale includes the following response options:

Strongly Disagree: Indicates a firm rejection of the statement. Disagree: Shows a general opposition to the statement, but less intense than "Strongly Disagree." Neither Agree Nor Disagree: Represents a neutral position, suggesting indecision or a balanced view.

Agree: Expresses support for the statement, but not with full intensity. Strongly Agree: Demonstrates strong approval or endorsement of the statement. 2

Assessment of patient satisfaction using 100 point scale (1 lowest- 100 highest satisfaction)

EQ-5D-5L consists of 2 pages - descriptive system and the EQ visual Analogue scale (EQ-VAS). The descriptive system comprises 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The EQ VAS records the respondents self-rated health on a 20 cm vertical, visual analogue scale with endpoints labelled "the best health you can imagine" and " the worst health you can imagine"

Low Anterior Rectum Syndrome (LARS) questionnaire, assessed by the patient. The LARS Score was developed in 2012 and represents an international, validated, simple and quick instrument to assess bowel function and allows quantitative evaluation of severity of functional defects. It consists of 5 questions with a score that ranges from 0 to 42 points, with classification of patients into: no LARS (0-20), minor LARS (21-29) or major LARS (30-42 points). The five very disabling bowel symptoms of LARS score (any flatus or liquid incontinence, altered stool frequency, faecal clustering and faecal urgency) will be analysed and rated by the patients, because of their known negative influence on quality of life.

Hernia will be evaluated according to the EHS classification (European Hernia Society), Incisional hernia is defined as an "abdominal wall gap with or without bulge in the area of a postoperative scar perceptible or palpable by clinical examination or imaging" according to the definition to the European Hernia society